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Jill P Ginsberg

Publications and source records attributed to Jill P Ginsberg.

13 recordsLinked to original sources
PubMed2007

Assessing functional mobility in survivors of lower-extremity sarcoma: reliability and validity of a new assessment tool.

BACKGROUND: Reliability and validity of a new tool, Functional Mobility Assessment (FMA), were examined in patients with lower-extremity sarcoma. FMA requires the patients to physically perform the functional mobility measures, unlike patient self-report or clinician administered measures. PROCEDURE: A sample of 114 subjects participated, 20 healthy volunteers and 94 patients with lower-extremity sarcoma after amputation, limb-sparing, or rotationplasty surgery. Reliability of the FMA was examined by three raters testing 20 healthy volunteers and 23 subjects with lower-extremity sarcoma. Concurrent validity was examined using data from 94 subjects with lower-extremity sarcoma who completed the FMA, Musculoskeletal Tumor Society (MSTS), Short-Form 36 (SF-36v2), and Toronto Extremity Salvage Scale (TESS) scores. Construct validity was measured by the ability of the FMA to discriminate between subjects with and without functional mobility deficits. RESULTS: FMA demonstrated excellent reliability (ICC [2,1] >or=0.97). Moderate correlations were found between FMA and SF-36v2 (r = 0.60, P < 0.01), FMA and MSTS (r = 0.68, P < 0.01), and FMA and TESS (r = 0.62, P < 0.01). The patients with lower-extremity sarcoma scored lower on the FMA as compared to healthy controls (P < 0.01). CONCLUSION: The FMA is a reliable and valid functional outcome measure for patients with lower-extremity sarcoma. This study supports the ability of the FMA to discriminate between patients with varying functional abilities and supports the need to include measures of objective functional mobility in examination of patients with lower-extremity sarcoma.

Amputation, Surgical↗
PubMed2007

A comparative analysis of functional outcomes in adolescents and young adults with lower-extremity bone sarcoma.

BACKGROUND: Comparison of functional mobility and quality of life is performed in patients with lower-extremity bone sarcoma following either amputation, limb-sparing surgery, or rotationplasty with four different types of outcome measures: (1) an objective functional mobility measure that requires patients to physically perform specific tasks, functional mobility assessment (FMA); (2) a clinician administered tool, Musculoskeletal Tumor Society Scale (MSTS); (3) a patient questionnaire, Toronto Extremity Salvage Scale (TESS); and (4) a health-related quality of life (HRQL) measure, Short Form-36 version 2 (SF-36v.2). PROCEDURE: This is a prospective multi-site study including 91 patients with lower-extremity bone sarcoma following amputation, limb-sparing surgery, or rotationplasty. One of three physical therapists administered the quality of life measure (SF-36v.2) as well as a battery of functional measures (FMA, MSTS, and TESS). RESULTS: Differences between patients who had amputation, limb-sparing surgery, or rotationplasty were consistently demonstrated by the FMA. Patients with limb sparing femur surgery performed better than those patients with an above the knee amputation but similarly to a small number of rotationplasty patients. Several of the more conventional self-report measures were shown to not have the discriminative capabilities of the FMA in these cohorts. CONCLUSION: In adolescents with lower-extremity bone sarcoma, it may be advantageous to consider the use of a combination of outcome measures, including the FMA, for objective functional mobility assessment along with the TESS for a subjective measure of disability and the SF-36v.2 for a quality-of-life measure.

Adolescent↗
PubMed2006

Pulmonary function abnormalities in children treated with whole lung irradiation.

BACKGROUND: We sought to determine the prevalence of abnormal pulmonary function tests (PFTs) in a cohort of children who had received whole lung irradiation (WLI) for treatment of metastatic disease. PROCEDURE: This was a retrospective (1988-2003) chart review that included all children treated at our institution with WLI who had undergone PFT. Data abstracted included oncologic diagnosis, radiation dose and fractionation, spirometry (FVC, FEV1, FEV1/FVC, FEF25%-75%), plethysmography (TLC, FRC, RV, RV/TLC), diffusing capacity (DLCO), and respiratory muscle strength (MIP, MEP). PFTs were normalized according to standard deviation (Z) scores. RESULTS: Thirty patients were identified who had one or more PFT. The incidence of mild, moderate, or severe reductions in FEV1 was 30%, 10%, and 10%, respectively, with 50% having normal FEV1. Seventeen percent of patients had mild reduction in total lung capacity (TLC), while 13% and 30% had moderate or severe reductions. Thirty-eight percent had mild reductions in diffusing capacity, while 29% and 14% had moderate or severe reductions. CONCLUSIONS: Pulmonary function abnormalities were common in this cohort of children treated with WLI, and may be progressive in nature. Further studies are warranted to identify patients at highest risk.

Adolescent↗
PubMed2006

Delivering long-term follow-up care to pediatric cancer survivors: transitional care issues.

One of the major challenges faced by young adult survivors of childhood cancer is the transition from a specialized pediatric care facility to adult-based health care that provides appropriate follow-up. This review summarizes the issues regarding the necessity of this transition, including a brief history of follow-up care of childhood cancer survivors. The general principles of transition care, as well as the barriers and obstacles specific to this population are outlined with the advantages and limitations of several models of transition care that could be considered.

Adolescent↗
PubMed2005

Preventing organ-specific chemotherapy toxicity.

Recent advances in treatment for pediatric cancers has increased overall survival rates. As more and more survive pediatric cancer, we continue to see the emergence of late effects of treatment within pediatric and the growing adult survivor population. The evaluation of late effects was initiated approximately two decades ago, and has become an extremely important facet of pediatric oncology. This review delves into several of the most serious organ-specific late effects of pediatric cancer treatment, outline what we know and what we do not currently understand about preventing or reducing them. Clinical and bench research are necessary to develop interventions that will avoid or mitigate late effects and improve the health of pediatric cancer survivors.

Antineoplastic Agents↗
PubMed2005

Fertility in males treated for Hodgkins disease with COPP/ABV hybrid.

More than 80% of those diagnosed with Hodgkins disease (HD) will survive long-term. For the past decade, a modified hybrid consisting of cyclophosphamide (2.4-3.6g/m(2)), vincristine, procarbazine, and prednisone (COPP) together with adriamycin, bleomycin, and vinblastine (ABV) has been used to treat patients with HD. Little data exists on how this modified hybrid impacts male fertility. Eleven male patients treated with COPP-ABV hybrid were studied. Nine out of 11 subjects were categorized as infertile by semen analysis; 7 of 9 were azoospermic. There was no association between fertility status and prepubertal status at diagnosis or gonadotropin status. Despite lower doses of cyclophosphamide, treatment with the current COPP/ABV hybrid leads to infertility in the majority of young men. It is likely that procarbazine, an effective yet potent gonadotoxic agent, is responsible for this outcome.

Adolescent↗
PubMed2005

Growth hormone releasing hormone plus arginine stimulation testing in young adults treated in childhood with cranio-spinal radiation therapy.

OBJECTIVE: Growth hormone deficiency (GHD) secondary to cranio-spinal radiation therapy (CSRT) is a complication seen in medulloblastoma survivors. The standard for diagnosis of adult GHD is a peak GH < 3 microg/l by the insulin tolerance test (ITT). However, insulin tolerance testing exposes patients to the risks of hypoglycaemia. Recent studies suggest that the GH releasing hormone + arginine (GHRH + ARG) test can identify GHD in cranially irradiated patients at longer time intervals after radiation. We evaluated the GHRH + ARG stimulation test compared to the ITT in young adults diagnosed with medulloblastoma during childhood. PATIENTS: We evaluated 10 young adult patients (age range 17-26 years) who were treated with CSRT during childhood for medulloblastoma, and who had resultant childhood-onset GHD. MEASUREMENTS: Subjects underwent GH provocative testing with the ITT and the GHRH + ARG test. IGF-I and IGFBP3 levels were also measured at baseline. RESULTS: Insulin tolerance testing and GHRH + arginine stimulation were performed at a mean +/- SD 14 +/- 4.4 years after cranial radiation. All patients failed the ITT with median peak GH 0.40 microg/l (range < 0.05-2.2). GHRH + arginine gave higher peak GH levels with a mean of 7.9 +/- 5.7 microg/l (P = 0.003). Four patients had peak GH > 9 microg/l and were between 7.8 and 19.6 years from cranial radiation. There was no correlation of peak GH levels with time interval since CSRT. Thirty-three per cent of subjects had normal IGF-I; neither IGF-I nor IGFBP3 standard deviation scores (SDS) correlated with ITT results. CONCLUSIONS: Using a GHRH + arginine cut-off for GHD of 9 microg/l, four patients would have been misclassified as GH sufficient, despite being > 7 years (with two patients being nearly 20 years) out from CSRT. These findings suggest that the pituitary GH-producing cells of young adults continue to maintain responsiveness to GHRH + arginine more than 5-10 years after cranial irradiation.

Adolescent↗
PubMed2005

Desmoplastic small round cell tumor in the abdomen and pelvis: report of CT findings in 11 affected children and young adults.

OBJECTIVE: Our objective was to evaluate the CT features of desmoplastic small round cell tumor (DSRCT) of the abdomen and pelvis in pediatric and young adult patients. CONCLUSION: Characteristic CT features of DSRCT include bulky intraabdominal soft-tissue masses that involve omental and serosal surfaces, without a distinct organ of origin; solid, dominant, heterogeneous pelvic masses in the retrovesical or rectouterine spaces; and concurrent metastases, common at the time of diagnosis, particularly those involving lymph nodes and liver.

Abdominal Neoplasms↗
PubMed2004

Using health-related quality of life measures to predict cardiac function in survivors exposed to anthracyclines.

PURPOSE: As the number of pediatric cancer survivors increases, so does the number of survivors previously exposed to anthracyclines as part of their cancer therapy. Because screening is costly, some have suggested that health-related quality of life (HRQL) measures might be useful in focusing screening tests on those patients with cases most likely to display positive findings. This study reports on the predictive ability of HRQL measures to detect patients with abnormalities on serial cardiac testing. METHODS: Using 127 patients from the ACE-Inhibitor after Anthracycline (AAA) Trial, this study compared serial measures of the Short Form-36 (SF-36; for ages > 13 years) and Child Health Questionnaire-Child Form 87 (CHQ-CF87; for ages < or = 13 years) to serial cardiac performance tests including echocardiographic shortening fraction, left ventricular end systolic wall stress (LVESWS), LVESWS-index, and maximal cardiac index (MCI; a measure of cardiac output at peak exercise). RESULTS: Generally, there was no clinically or statistically significant correlation between any HRQL measure and any cardiac function measure except between MCI and vitality and physical functioning. For each of these measures, the correlation between MCI was statistically significant (P < .006), but each HRQL subscale could explain no more than 7% of the variation in MCI. HRQL measures were not predictive of any other cardiac function measure. CONCLUSION: HRQL measures should not be used in isolation as a screen for cardiac function abnormalities in patients exposed to anthracylines who already have a mild degree of ventricular dysfunction. Patient history appears to be no substitute for cardiac testing in this cohort.

Adolescent↗
PubMed2004

An examination of outcome measures to assess functional mobility in childhood survivors of osteosarcoma.

BACKGROUND: The purpose of this study is to examine outcome measures that assess functional mobility in adolescent survivors of osteosarcoma. We will also identify relationships between functional mobility measurements and specific measure(s) of health-related quality of life (HRQL). METHODS: Eighteen adolescent survivors of osteosarcoma at least 2 years from surgery at the Children's Hospital of Philadelphia (CHOP) participated in this study. Functional mobility, endurance, perceived exertion, and locomotor efficiency is examined with the following measurement tools: timed up and go (TUG), timed up and down stairs (TUDS), 9-min run-walk, rate of perceived exertion (RPE), and physiological cost index (PCI). The currently used evaluation of function from the American Musculoskeletal Tumor Society (MSTS) is also administered. The Short Form 36 (SF-36) measuring HRQL is used. RESULTS: MSTS scores did not correlate with quantitative functional outcome measures. MSTS scores did not correlate with the HRQL as measured by the SF-36. In contrast, subjects with a higher rate of vitality on the SF-36 walked with more efficiency, farther distance during the 9-min run-walk, and performed the TUDS and TUG with a faster speed. CONCLUSIONS: The MSTS does not correlate with actual measures of function or with HRQL. These data demonstrate the need for a new measure to determine functional mobility in survivors of osteosarcoma.

Adolescent↗
PubMed2004

Prevalence of and risk factors for hydrocele in survivors of Wilms tumor.

BACKGROUND: The purpose of this study is to evaluate the prevalence of hydrocele as a complication of Wilms tumor (WT) therapy and nephrectomy and to determine whether radiation therapy to the flank increases the risk. We hypothesize that radiation increases the risk of hydrocele formation in patients treated for WT. METHODS: A retrospective, medical review of the chart was completed on 57 male patients with WT diagnosed between 1985 and 2000. RESULTS: There is an increased prevalence of hydrocele in males that had a nephrectomy as part of their WT therapy. CONCLUSIONS: Male survivors of WT are at risk for development of a subsequent hydrocele that appears to be related to their prior surgery.

Chi-Square Distribution↗
PubMed2002

Isolated extramedullary relapse in acute myeloid leukemia: A retrospective analysis.

BACKGROUND: Little is known about the characteristics and outcome of children with acute myeloid leukemia (AML) experiencing an isolated extramedullary relapse (IEMR). PROCEDURE: The tumor registry of The Children's Hospital of Philadelphia identified 215 patients with AML diagnosed between 1970 and 2000, of which 16 (7.4%) experienced IEMR. Patient- and disease-related features and outcome of patients with IEMR and other patients with AML were compared. RESULTS: IEMR occurred a median of 4.5 months (1.5-74 months) from diagnosis. Male to female ratio was 4.3:1 in patients with IEMR and 1.1:1 in the other patients with AML (P = 0.048). Median age at diagnosis and median presenting WBC were not significantly different in patients with and without IEMR. Patients with IEMR were more likely to have extramedullary disease (EMD) at diagnosis (31 vs. 4.5%) (P =.002) and FAB M4 or M5 morphology (P =.0001). Leukemic cells in 7 of 13 patients (54%) had t(11q23), inversion 16 or t(8;21) with IEMR compared to 21 of 93 other patients (23%) (P = 0.166). Six of 16 (37.5%) patients survive a median of 4.5 years (range 1.5-15 years) after IEMR and there are 13 survivors (23%) of 57 patients after marrow or combined relapse (P = 0.56). One survivor of IEMR received local irradiation and continued on maintenance therapy while the other five received chemotherapy, irradiation, and allogeneic marrow transplant in second or third remission. CONCLUSIONS: Patients with isolated EMR are typically young males with monoblastic or myeloblastic leukemia who present with EMD at diagnosis. Marrow transplant following chemotherapy and local radiotherapy offer the potential for long-term survival.

Adolescent↗